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Clinic Information
* Clinic Name : 
* Clinic ID : 
 
 
Your Job Title
   
 
 
* Trainer's Name : 
 
 
 
Start Date:
MonthDayYear
  
 
 
End Date:
MonthDayYear
  
 
How satisfied were you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied N/A
The overall training experience
The relevancy of the topics to my job
The knowledge the trainer demonstrated
The preparation and punctuality of the trainer
The time the trainer took to fully understand my questions
The ability of the trainer to deliver clear and concise information
How was your experience with the overall data implementation
Ability to get the needed data converted into our software
 
 
 
Rate the pace of your training:
 
Too slow
 
Good
 
Too fast
 
 
 
Would you recommend this trainer to a colleague?
 
Yes
 
No
 
 
 
If no, please explain:
   
 
 
 
How could we improve your training experience?
   
 
 
 
Could you have used additional training days?
 
Yes
 
No
 
 
 
How many?
   
 
 
 
Would you like to be contacted by a supervisor to discuss your training experience further?
 
Yes
 
No
 
 
Contact information
Name : 
Phone : 
 
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